<{* Tell users about missing required fields *}>
<{if (isset($missingFields))}>
	<h3><{$smarty.const._MD_CONFREG_ERR_3}></h3>
	<ul>
	<{foreach from=$missingFields item=thisField}>
		<{assign var="fieldname" value="_MD_CONFREG_ERR_"|cat:$thisField}>
		<li><{$smarty.const.$fieldname}></li>
	<{/foreach}>
	</ul>
<{/if}>

<form action="register.php" method="post" class="f-wrap-1">
<div class="req"><b>*</b> <{$smarty.const._MD_CONFREG_REQUIREDFLD}></div>
<{* hidden fields hold already existing data *}>
<{if (isset($savedata))}>
	<{foreach key=field item=itemvalue from=$savedata}>
		<input type="hidden" name="<{$field}>" value="<{$itemvalue}>" />
	<{/foreach}>
<{/if}>

<fieldset>
<h3><{$smarty.const._MD_CONFREG_MAIL_TITLE}></h3>

<label for="company"><b><span class="req">*</span><{$smarty.const._MD_CONFREG_COMPANY}>:</b>
<input id="company" name="company" value="<{$formdata.company}>" type="text" class="f-name" tabindex="1" /><br />
</label>

<label for="mailaddress1"><b><{$smarty.const._MD_CONFREG_MAIL_1}>:</b>
<input id="mailaddress1" name="mailaddress1" value="<{$formdata.mailaddress1}>" type="text" class="f-name" tabindex="2" /><br />
</label>

<label for="mailaddress2"><b><{$smarty.const._MD_CONFREG_MAIL_2}>:</b>
<input id="mailaddress2" name="mailaddress2" value="<{$formdata.mailaddress2}>" type="text" class="f-name" tabindex="3" /><br />
</label>

<label for="mailcity"><b><{$smarty.const._MD_CONFREG_MAIL_CITY}>:</b>
<input id="mailcity" name="mailcity" value="<{$formdata.mailcity}>" type="text" class="f-name" tabindex="4" /><br />
</label>

<label for="mailstate"><b><{$smarty.const._MD_CONFREG_MAIL_STATE}>:</b>
<select id="mailstate" name="mailstate" tabindex="5">
<option value=""><{$smarty.const._MD_CONFREG_SELECT_STATE}>...</option>
<{section name=states1 start=1 loop=60}>
		<{assign var="state" value="_MD_CONFREG_STATE"|cat:$smarty.section.states1.index}>
		<option <{if $smarty.const.$state == $formdata.mailstate}> selected <{/if}>><{$smarty.const.$state}></option>
<{/section}>
</select>
<br />
</label>

<label for="mailzip"><b><{$smarty.const._MD_CONFREG_MAIL_ZIP}>:</b>
<input id="mailzip" name="mailzip" value="<{$formdata.mailzip}>" type="text" class="f-name" tabindex="6" /><br />
</label>

</fieldset>

<fieldset>
<h3><{$smarty.const._MD_CONFREG_BILL_TITLE}></h3>

<label for="fname"><b><{$smarty.const._MD_CONFREG_FNAME}>:</b>
<input id="fname" name="billfname" value="<{$formdata.billfname}>" type="text" class="f-name" tabindex="7" /><br />
</label>

<label for="lname"><b><{$smarty.const._MD_CONFREG_LNAME}>:</b>
<input id="lname" name="billlname" value="<{$formdata.billlname}>" type="text" class="f-name" tabindex="8" /><br />
</label>

<label for="phone"><b><{$smarty.const._MD_CONFREG_PHONE}>:</b>
<input id="phone" name="phone" type="text" value="<{$formdata.phone}>" class="f-name" tabindex="9" /><br />
</label>

<label for="paytype"><b><span class="req">*</span><{$smarty.const._MD_CONFREG_PAYTYPE}>:</b>
<select id="paytype" name="paytype" tabindex="10" />
<option value=""><{$smarty.const._MD_CONFREG_SELECT_PTYPE}>...</option>
<{section name=ptypes start=1 loop=6}>
		<{assign var="ptype" value="_MD_CONFREG_PTYPE"|cat:$smarty.section.ptypes.index}>
		<option <{if $smarty.const.$ptype == $formdata.paytype}> selected <{/if}>><{$smarty.const.$ptype}></option>
<{/section}>

</select>
<br />
</label>

<label for="billaddress"><b><{$smarty.const._MD_CONFREG_MAIL_1}>:</b>
<input id="billaddress" name="billaddress" value="<{$formdata.billaddress}>" type="text" class="f-name" tabindex="11" /><br />
</label>

<label for="billcity"><b><{$smarty.const._MD_CONFREG_MAIL_CITY}>:</b>
<input id="billcity" name="billcity" value="<{$formdata.billcity}>" type="text" class="f-name" tabindex="12" /><br />
</label>

<label for="billstate"><b><{$smarty.const._MD_CONFREG_MAIL_STATE}>:</b>
<select id="billstate" name="billstate" tabindex="13">
<option value=""><{$smarty.const._MD_CONFREG_SELECT_STATE}>...</option>
<{section name=states2 start=1 loop=60}>
		<{assign var="state" value="_MD_CONFREG_STATE"|cat:$smarty.section.states2.index}>
		<option <{if $smarty.const.$state == $formdata.billstate}> selected <{/if}>><{$smarty.const.$state}></option>
<{/section}>
</select>
<br />
</label>

<label for="billzip"><b><{$smarty.const._MD_CONFREG_MAIL_ZIP}>:</b>
<input id="billzip" name="billzip" value="<{$formdata.billzip}>" type="text" class="f-name" tabindex="14" /><br />
</label>

<{$smarty.const._MD_CONFREG_CONFIRM_EMAIL}>:<br />
<label for="confirmemail"><b><{$smarty.const._MD_CONFREG_EMAIL}>:</b>
<input id="confirmemail" name="confirmemail" value="<{$formdata.confirmemail}>" type="text" class="f-name" tabindex="15" /><br />
</label>

</fieldset>

<fieldset>
<div class="f-submit-wrap-right">
<{if isset($savedata)}>
<input type="submit" name="submit" value="<{$smarty.const._MD_CONFREG_PHRASE18}>" class="f-submit" tabindex="16" /><br />
<{else}>
<input type="submit" name="submit" value="<{$smarty.const._MD_CONFREG_PHRASE17}>" class="f-submit" tabindex="16" /><br />
<{/if}>
</div>
</fieldset>

</form>

<!-- do not remove the following copyright section -->
<div align="right">
<br>Conference Registration (c) 2006, <a href="http://www.superfantasmoworld.com/" title="Click to see software author's web page" target="_blank">Kevin van Haaren</a>
</div>
<!-- end of copyright section -->

